Frequently Asked Questions (FAQ)

The following list provides brief explanations of typical member or prospective member inquiries and are not meant to be contractual or implied contractual terms and conditions. Each member will receive and sign a member enrollment agreement which will govern any and all services provided. If you have specific questions regarding the program please call our Concierge Care Team at any time.

1. What is the Mission of emc2care?

The mission of emc2care is to provide the best possible healthcare we can to our patients with care, compassion and in an unhurried manner. We want to put the CARE back into healthcare and by moving to a member-based program in which you can rest assured that you will get the utmost in time, attention and medical care that Dr. Einstein has to offer as your doctor.

2. Why the move to Concierge or Membership Care?

The fact is that with the current healthcare environment, and expected changes with Government Healthcare coming quickly into play our practice cannot continue to provide the high quality healthcare we want to provide in the type of system that we anticipate is coming. By moving to a new business model we can provide you with the type of high quality healthcare that meets our standards and yours as well. This program will also allow for us to have additional staff to further provide you with excellent care and responsiveness that we will not be able to provide in the future due to the anticipated government “reforms.”

4. Are you on the Medical Staff of a Hospital?

No, but we will make every possible effort to continue to coordinate care with your surgeons and specialist physicians who would be treating you in the event of a hospitalization.

5. Who will cover for you when you are not available?

On infrequent occasions when Dr. Einstein is out of town or otherwise unavailable, he will have another concierge physician cover for him. In addition, Dr. Einstein’s outstanding Physicians Assistant Fairoz Radtke is available to assist with many of your healthcare needs. Even while out of town, Dr. Einstein will generally be available by phone to his patients and to his covering physicians. For practical reasons, we reserve the right to designate another qualified physician to perform any and all services should the need arise.

6. Do you take Insurance?

PPO Patients
Alpharetta Medical Associates, P.C. is an In-Network provider for Blue Cross Blue Shield of Georgia and United Healthcare as well as a few other plans (please call your individual plan provider if you have any questions regarding in-network providers. Alpharetta Medical Associates accepts all other insurance as an Out-of-Network provider. We accept the straight Medicaid plan, but none of the subgroup or HMO plans for Medicaid. Regardless of your plan, we will continue to bill your insurance for all covered services. It is our intention that no medical services which are covered by a patient’s health insurance or plan are included in the services covered by your annual concierge membership fee.

Medicare Patients
Alpharetta Medical Associates, P.C. participates fully in the Medicare program. Per Medicare regulations, the annual exam benefit portion of the emc2care Service cannot be included for patients who are new beneficiaries in the Medicare program in a given year. As of January 2005, Medicare established a one-time reimbursement to physicians who offer the “Welcome to Medicare” exam to new Medicare beneficiaries. This exam must be billed to Medicare except for any Medicare co-pay, for which the patient will be responsible. Please advise us if you have recently turned 65 when you sign on with the practice. It is our intention that no insurance-covered medical services are included in your annual fee. We do provide Medicare patients with additional benefits as part of our program if they are covered for their “Welcome to Medicare” exam during a given year.

HMO/Medicare HMO Patients
Unfortunately, HMO patients will not be able to join the practice until they transition to either a PPO or traditional Medicare plan.

7. Do I still need Insurance if I enroll?

Yes. Concierge medical practices do not take the place of general health insurance coverage. Rather, they are a medical care practice. You are advised to continue your PPO, Medicare or other insurance program. If you are an uninsured individual and desire to enroll in the practice, we will provide you with the practice’s standard fee schedule for office visits, tests and procedures.

8. Will my insurance still be billed for my office visits?

Yes, if the services we provide during the office visits are considered to be covered services by your insurance carrier or plan, we will bill your insurance company directly for those office visits and services. Office visit charges, with the exception of your annual wellness exam, are not included in your emc2care annual fee.

9. What about Co-Payments?

If you have PPO insurance, we will continue to collect all co-payments and deductibles as outlined in your insurance plan.

10. What if I do not want to enroll, can I still see Dr. Einstein?

If you are currently a patient at Alpharetta Medical Associates you will still be able to book appointments until the emc2care program enrollment is full. If you choose not to take advantage of the new program, once the program is full, Dr. Einstein we no longer be able to see non-members, and we will assist you with a referral to another practice or doctor. In accordance with Georgia law, we have sent notification to all of Dr. Einstein’s patients of this change and explaining that the maximum patient enrollment will be 600 patients, and that we will give patients at least ninety (90) days from the notice to continue care with him if they are not electing to enroll in the concierge program.

11. What happens when the practice hits the maximum preliminary enrollment of 600 members?

Either before at the time emc2care reaches 600 patients we will add another doctor to the practice so that the program can expand. The program will continue to be a concierge care practice as we add additional doctors and staff.

12. Who do I call after hours?

You will be able to contact our staff and the doctor after hours. You will have a private number so that you will have complete access including email, text messaging, cell phone and patient care personnel.

13. How are payments made?

Payments can be made annually, semi-annually, quarterly or monthly with auto billing and you can use check, Visa, Master Card, Discover and American Express. We will also be adding Paypal and other online payment methods through the website. Montly and Quarterly Billing must be by ACH or Credit Card.

14. Will you be adding additional Doctors to the practice?

As the program grows to near full enrollment, we do plan to add an additional doctor to the practice. We are currently in the interview process for a new doctor and nurse for the practice to provide even better access to care. We are dedicated to having a team of health care specialists and professionals that will create an efficient environment.

15. Do you file Medicare for the annual membership fee?

No. The annual concierge fee only includes services that are not covered by Medicare and, as such, cannot be paid for or reimbursed by Medicare. We will bill Medicare for your sick visits and for any additional services performed at this practice that ARE covered by Medicare.

16. Will my private insurance reimburse my annual membership fees?

No, private insurance does not typically reimburse for the annual concierge fee. However, some, but not all, Flexible Spending Account (“FSA”) and Health Savings Account (“HAS”) plans may pay for all or part of the annual fee. Members with FSAs and HSAs are advised and strongly encouraged to consult their human resources representative at their place of employment or their individual health insurance agent or advisor for further coverage information.

17. Is the annual membership fee tax deductible?

In many cases the concierge fee may be a tax-deductible healthcare expense. Patients are advised to consult with their tax consultant or accountant to clarify qualification in their particular circumstance.

18. What about labs, x-rays, specialist fees and hospitalization?

Your annual fee pays for membership in the practice, for your annual wellness exam, and for many other amenities. However, all other procedures and services not performed in the emc2care office will be billed by the performing entity and should be covered as “in-network” benefits, or will be the patient’s financial responsibility.

19. Are there age limits?

Dr. Einstein is an Internal Medicine physician. His specialty is Adult medicine. Dr. Einstein is trained to manage acute and chronic medical illnesses among adults. As such, the practice is limited to patients 16 years of age and older. Our program covers all children still living at home from the ages of 16-22 at no additional charge.

20. What if I have an emergency?

If you have a life-threatening emergency, call 911 immediately. After you call 911, please call Dr. Einstein. He will attempt to coordinate your emergency care thereafter. Patients are asked to contact Dr. Einstein before going to any urgent care facility and at any time of the day or night. Dr. Einstein will attempt to address urgent after-hours problems directly.

21. How far in advance do I need to Book Appointments?

Dr. Einstein is committed to providing his patients with easy access to care. All visits are a priority and will be accommodated to meet your needs. Same day or next day appointments will be available, placing the greatest priority on the sickest patients. Annual physical exams and/or Risk Assessments must be booked in advance. We ask that you please call ahead to schedule office visits;, however, acute, urgent illnesses will be accommodated to meet your needs.

22. What about travel?

Call 911 if you have a life-threatening emergency. Then call Dr. Einstein. If the problem is minor, Call Dr. Einstein. With the exception of a few controlled substances, most prescriptions can be ordered anywhere in the country. If necessary, it may be possible for Dr. Einstein to find a resource in your area. As a member of SIMPD you will have access to a large number of affiliate doctors through our relationship. If you seek care at an emergency room or urgent care center out of our area, we request that you have the doctor seeing you call Dr. Einstein for coordination. Dr. Einstein will be readily available by phone for consultation with you and/or other health care personnel. If you should require hospitalization while away, at your request, Dr. Einstein will establish phone communication with you and your attending physician(s) to ensure continuity of care.

23. Do you make house calls?

House calls will be available to emc2care members on an as-needed basis and within a limited radius from the office. These will be done as deemed appropriate by Dr. Einstein on a case-by-case basis. Home visits will be charged as an office visit would be charged to the patient’s insurance or to the patient directly.

24. What if I need a specialist or surgeon?

Of course, emc2care patients are free to see any specialist they wish. We are available to help you decide what specialists to see and to coordinate such consultations. In this way the most appropriate resource is used, the earliest arrangements are made, and your applicable medical information is sent in advance of your specialist visit.

25. Does this effect cost of prescription medications?

Usually no, the cost of prescription medications are the patient’s responsibility and in most cases should be covered by their insurance plans. We have expertise in assisting patients in purchasing medications in the most cost effective manner.

26. Do you require the annual membership fee if I do not use the services?

Yes. Paying your concierge fee allows you to be a member of the practice whether you are sick or well. However, emc2care is not an insurance company and does not cover the medical services you receive. We strongly encourage you to utilize the amenities offered including wellness consultations and emails for appropriate non-urgent health related questions, regardless of your state of health.

27. Referral Discount Program

The initial referral program offered by emc2care expired on July 31, 2009. All membership fees are standardized from that date going forward. If you enrolled prior to July 31, 2009 your spouse referral fees will be honored. Please remember that previous referral fees are prorated based on payment schedule during the first year.

28. Program Pricing Schedule

The annual fee for the emc2care member program is $125.00/month USD for each adult member. For a limited time emc2care is offering to allow for dependent children between the ages of 16 and 22 to be included in with a member parent. This program is valid until September 30, 2009. At that time unmarried dependent children will be billed at $49/month.

If you have further questions please call our info line at 800.858.3013